| Lake Park Dental Llc | |
|
2524 E Webster Pl Ste 201 Milwaukee WI 53211-4257 | |
| (414) 963-9440 | |
| Not Available |
| Full Name | Lake Park Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2524 E Webster Pl Ste 201, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Megan E Graham (OWNER) |
| Authorized Official Contact | 4149639440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Park Dental Llc 2524 E Webster Pl Ste 201 Milwaukee WI 53211-4257 Ph: (414) 963-9440 | Lake Park Dental Llc 2524 E Webster Pl Ste 201 Milwaukee WI 53211-4257 Ph: (414) 963-9440 |
| NPI Number | 1184279028 |
|---|---|
| Provider Enumeration Date | 08/07/2019 |
| Last Update Date | 08/07/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184279028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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